Control of myopia: Controlling Myopia and Halting Its Growth

When your eyes have problems concentrating on distant things, this condition is known as myopia, commonly called nearsightedness. Usually, when light enters your eye, it passes through your cornea, iris, and lens before landing on your retina and transmitting signals to your brain via the optic nerve.

Myopia causes light to fall in front of your retina rather than directly on it, which can result in:

Vision distortion
greater squinting
Chronic headaches
Reading poorly at night

Nearly 30% of Canadians have myopia. Children of school age can initially experience the disease, which can worsen over time. Control strategies for myopia aid in halting its development. These treatments include contact lenses, eye medications, and corrective eyewear.

Finding the ideal method to slow myopia development might significantly impact your child's life. During school or other activities, they may develop eye fatigue and vision problems, impairing their ability to learn and grow.

How is myopia treated?

Myopia control is a collection of techniques that eye specialists can employ to stop the progression of myopia in children. Although no known treatment for myopia exists, there are techniques to slow its onset or progression. These include atropine eyedrops, atropine contact lenses, and atropine glasses for myopia correction.

Why should you be concerned about preventing myopia? Preventing your youngster from becoming hyperopic by reducing myopia progression. Later in life, high myopia might cause vision-threatening issues like:

Myopia-related macular aging
Nuclear and posterior subcapsular cataracts are both types of cataracts.
Open-angle glaucoma is primary.
retinal separation

All the eye-health care a myope might require is included in myopia management. It covers everything from detecting childhood myopia to dealing with its adult-life implications. Myopia care must include myopia control.

The goal of myopia control is to slow down the development of myopia (nearsightedness) in people, especially in youngsters. Although the precise mechanisms underlying the onset and progression of myopia are not fully known, several methods are used to treat and control it. Here is a description of how several popular myopia prevention techniques function:

Outdoor activities: Time spent outside, particularly in daylight, has been linked to a lower risk of myopia onset and progression. Although the precise cause of this effect is still under investigation, exposure to solid outdoor light may have a positive impact on controlling eye development and preventing the elongation of the eyeball that is linked to myopia.
Reduced near work and digital device use: Using digital gadgets or reading for extended periods at close range can strain the eyes and accelerate the growth of myopia. The eyes can relax, and the pressure on the focusing mechanism is reduced by reducing the time spent on these activities and taking frequent pauses, which may help prevent the advancement of myopia.
Orthokeratology (Ortho-K): Ortho-K requires the overnight use of rigid gas-permeable contact lenses that have been carefully constructed. These lenses temporarily restructure the cornea, enabling daytime vision without glasses or contact lenses. Ortho-K is thought to affect the peripheral defocus of the eye, which may have an impact on eye growth and slow down the elongation of the eyeball. The precise mechanism by which Ortho-K slows the advancement of myopia has yet to be entirely understood.
Multifocal Contact Lenses: Contact lenses with various zones for near, mid, and far vision are known as multifocal lenses. These lenses may aid in controlling myopia progression and can assist in refocusing peripheral light that enters the eye. The peripheral defocus, and consequent slowing of eye growth are believed to be affected by the particular optical design of multifocal lenses.
Low-dose atropine eye drops: Atropine is a drug that relaxes the eye's focusing process and briefly enlarges the pupil. It has been demonstrated that using low-dose atropine eye drops can stop the progression of myopia. Although the precise process by which atropine reduces myopia is still not entirely known, it is thought to involve the modulation of neurotransmitters and ocular growth hormones that can affect eye development.

It's vital to remember that myopia control techniques might employ a combination of these and possibly additional, as-yet-unidentified mechanisms. The efficacy of each technique varies from person to person, so the best myopia management strategy should be selected after discussing the individual's unique situation with a trained eye care specialist.

Solutions to control myopia

There are now three major categories of interventions for controlling myopia. They all function differently to stop the growth or advancement of myopia:

Lenses: orthokeratology, myopia-control contact lenses, and myopia-control eyewear
Eye drops: Atropine ocular drops at a low dose
Changes in routine: More time spent outside and less time spent on activities that are too strenuous close to work.

Contact lenses for controlling myopia

1. Environmental aspects and alterations to lifestyle

The development of myopia has been connected to increased screen time or close work. It explains why the evolution of myopia after the epidemic has suddenly increased. Children are more likely to develop myopia the closer they get to labor. The most significant risk factor for myopia advancement is being close to work. So, cutting back on screen time would reduce the growth of myopia. The American Academy of Ophthalmology has also advised how much screen time is appropriate for kids of different ages.

Additionally, studies have revealed that a specific amount of U.V. exposure from natural light is required to lower the risk of myopia progression. As a result, it is advised that parents let their kids spend more time outside. In addition, being outside allows us to focus on distant objects more than indoors, which is thought to slow the growth of myopia. The three fundamental lifestyle changes required to control myopia are summarised in the following graph.

2. Spectacle lenses with unique myopia-controlling features

Myopia can be controlled and corrected using special lenses. It is a decent option for myopia management because wearing glasses is usually more straightforward. To control myopia, spectacle lenses with DIMS and H.A.L.T. technology go above and beyond regular lenses. Consider the H.A.L.T. (Highly Aspherical Lenslet Target) and DIMS (Defocus Incorporated Multiple Segments) technologies as myopia-correcting single-vision lenses with an extra "treatment zone" on top of the conventional lenses.

The development of myopia control eyewear has undergone extensive investigation over the last eight to ten years. According to studies, these novel designs can stop the progression of myopia by more than 60%.

Myopia-control contacts and spectacles both function similarly. By causing peripheral myopic defocus, they can reduce the lengthening of the eyeball.

Sadly, the United States still lacks myopia-control glasses that have received F.D.A. approval. However, the MiYOSMART lens by Hoya and the Stellest lens by Essilor are two fascinating examples. In 2021, the F.D.A. granted the Stellest lens its Breakthrough Device designation.

Myopic defocus is produced by Stellest using HALT (Highly Aspherical Lenslet Target) technology.
Myopic defocus is produced by MiYOSMART using D.I.M.S. (Defocus Incorporated Multiple Segments) technology.

To stop the advancement of myopia, some doctors also employ ordinary multifocal lenses. Although they have some effectiveness, myopia-control glasses prevent advancement more effectively.

3. Orthokeratology

Orthokeratology, which involves making rigid gas-permeable contact lenses, can temporarily fix or eliminate refractive errors by changing the shape of the cornea. Its foundation is the concept of reverse geometry. OrthoK lenses press against the center corneal surface, altering the cornea. It reduces the eye's axial length and focusing capacity by flattening the cornea, or the front portion of the eye.

According to studies, corneal reshaping causes the lenses to produce a plus-powered ring in the peripheral vision due to increased cell count, similar to soft multifocal contact lenses and DIMS eyeglasses. The child is supposed to put on the OrthoK lenses at night before sleeping to have a good night's rest. The patients with the best outcomes have myopia up to -5.00 dioptres. For refractive defects greater than -5.00, a unique OrthoK lens must be created. Infections are a significant worry for parents, so Prof. Mark Bullimore looked into the possibility of an infection in kids who wore OrthoK lenses overnight and discovered a risk of less than 1%, provided the lenses' care and maintenance instructions were followed correctly.

4. Atropine eye drops

Controlling myopia can be accomplished with the aid of atropine eye drops. They have a small amount of atropine, temporarily widening the pupil and easing the eye's focusing muscles. Here are some essential details about atropine eye drops for controlling myopia:

5. Mechanism of action: It is unclear precisely how atropine eye drops stop the growth of myopia. The manipulation of neurotransmitters and growth hormones in the eye, which can affect eye growth, is thought to be involved. Atropine eye drops function by lowering the eye's accommodating response and perhaps influencing the signaling pathways contributing to myopia development.

Low-dose concentration: A low-dose concentration of atropine eye drops, such as 0.01% or 0.05%, is commonly used to correct myopia. The adverse effects of atropine, such as pupil dilatation and near vision blur, that are brought on by higher doses are lessened by these low concentrations.
Application and prescription: An eye doctor's prescription is required to obtain atropine eye drops. The affected eye(s) receive the drops daily, typically just before night. It is crucial to adhere to the eye care professional's dose and application recommendations.

Atropine eye drops are typically used as a long-term treatment for controlling myopia. The course of treatment may differ depending on the patient's response to the drug and the degree of myopia. Regular follow-up appointments with an eye care specialist are required to track the development of myopia and modify the treatment strategy as appropriate.

How can I choose the best myopia treatment?

It is suggested that your child receive myopia control in some way if they have the condition. The child's age, maturity level, and lifestyle all play a significant role in whether orthokeratology or multifocal lenses are suitable. Typically, children can start wearing contact lenses at the age of 8.

The degree of nearsightedness is a consideration. Corneal reshaping could only work better if the refraction level were lowered. To determine if your child's prescription can be treated with ortho-k, speak with Dr. Barbara Marcussen at the Myopia Control Center At Complete Eye Care.

An essential factor is lifestyle. A child who enjoys playing outside can find eyeglasses or dusty conditions bothersome when using contacts. Ortho-K is the preferable option for these kids.

Consider using atropine drops if you choose corrective lenses (contacts or glasses). They are ideal for young children and have minimal to no adverse effects.

Conclusion

The management and slowed advancement of myopia are the goals of myopia control measures. People may slow down myopia progression by engaging in outdoor activities, cutting back on close work, using specialist contacts, or using low-dose atropine eye drops. Effective myopia control requires working with a qualified eye care practitioner and following a unique treatment plan.

Casey Optical Too, LLC, offers a warm and comprehensive environment that addresses all your eye care needs. We invite you to schedule an appointment with one of our top optometrists and experience the difference for yourself. Your vision is our priority, and we are dedicated to serving our community with excellence.

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Control of myopia: Controlling Myopia and Halting Its Growth

How is myopia treated?

Solutions to control myopia

Contact lenses for controlling myopia

How can I choose the best myopia treatment?

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